Pelvis/Pelvic Floor

Question 1

The pelvis is divided into 2 regions by ___

Answer 1

pelvic brim

Question 2

What are the two regions of the pelvis?

Answer 2

false pelvis (greater pelvis)

true pelvis (lesser pelvis)

Question 3

Describe the borders of the false pelvis

Answer 3

false pelvis aka greater pelvis

bordered by iliac crest all the way down to pubic symphysis at sacroiliac joint

pelvic inlet is continuous with the abdominal cavity

Question 4

Describe the borders of the true pelvis

Answer 4

pelvic outlet is closed off below by muscular pelvic floor

Question 5

What are the pouches in the pelvic cavity male vs. female

Answer 5

Male: rectovesical pouch

Female: recouterine pouch and vesicouterine pouch

Question 6

Are the viscera of the pelvic cavity retroperitoenal or intraperitoneal? Why?

Answer 6

Retroperitoneal

Because pelvic cavity is lined with continuum with the peritoneum from the abdominal cavity

Question 7

The pelvis is made up of what bones?

Answer 7

1 sacrum (5 fused sacral vertebrae)

2 os coxae (ileum, ischium and pubis)

Question 8

Describe the sexual dimophism of the pelvis

Answer 8

Female:

• Oval to rounded pelvic brim
• Wider pubic arch with subpubic angle >80
• obturator foramen is oval
• acetabulum is small
• flared iliac wings (alae)
• Ischial tuberosities farther apart
• Sacrum shorter and less curved

Male

• heart shaped pelvic brim
• greater pelvis is deeper
• lesser pelvis is narrow and deep
• pubic arch is narrow with subpubic arch <70
• obturator foramen is round/heart shaped
• acetabulum is large

Question 9

What are the ligaments of the pelvis? 7

Answer 9

1. Pubic symphysis
2. Anterior sacroiliac lig
3. posterior sacroiliac lig
4. sacrotuberous lig
5. sacrospinous lig
6. obturator membrane
7. interosseos lig

Question 10

Describe the pubic symphysis

Answer 10

ligament of the pelvis

connects 2 pubic bones

Question 11

Describe the anterior sacroiliac ligament

Answer 11

ligament of the pelvis

crosses sacro-iliac joint anteriorly

broad

Question 12

Describe the posterior sacroiliac ligament

Answer 12

ligament of the pelvis

crosses sacroiliac joint posteriorly

broad

Question 13

Describe the sacrotuberous ligament

Answer 13

ligament of the pelvis

From ischial tuberosity to sacrum/coccyx

lower border of the lesser sciatic foramen

seen best posteriorly

Question 14

Describe sacrospinous ligament

Answer 14

ligament of the pelvis

from ischial spine to sacrum/coccyx

lower boundary of the greater sciatic foramen

seen best anteriorly

Question 15

Describe the obturator membrane

Answer 15

ligament of the pelvis

closes off obturator foramen

becomes lower border of obturator canal

Question 16

Describe interosseous ligament

Answer 16

ligament of the pelvis

between the sacrum and iliac in the sacroiliac joint

lies interosseous (bw bone) and between anterior and posterior sacroiliac ligaments so we cannot see it.

Question 17

What are the muscles of the pelvic walls?

Answer 17

1. Obturator internus muscle

2. Piriformis muscle

Question 18

Describe the location of the piriformis muscle

Answer 18

muscle of the pelvic wall

runs from anterior sacrum to greater trochanter of the femur

passes behind the greater sciatic notch and thru greater sciatic foramen

closes off the posterior/superior pelvic outlet

Question 19

Describe the location of the obturator internus muscle

Answer 19

muscle of the pelvic wall

runs from obturator foramen to greater trochanter

covered with thick fascia and attaches to levator ani as a tendinous arch

passes through greater sciatic foramen

Question 20

What is the innervation for the pelvis wall muscles?

Answer 20

obturator internus = L5/S1 innervation

piriformis muscle =S1/S2 innervation

Question 21

Do both obturator internus and pitiformis muscle act on hip joints?

Answer 21

yes.

Question 22

What are the apertures in the pelvic wall?

Answer 22

greater and lesser sciatic notches are subdivided by pelvic wall muscles/ligaments

sacriospinous ligament greaters lesser border of greater sciatic foramen

piriformis thru greater sciatic foramen creates space superior/inferiorto piriformis

sacrotuberous ligament creates inferior border of lesser sciatic foramen

obturator internus muscle creates space superior and inferior

Question 23

What does the pelvic diaphragm separate?

Answer 23

the pelvic cavity from the perineum

Question 24

What are the two components to the pelvic diaphragm?

Answer 24

Levator Ani muscles and Coccygenus muscles

^these are both bilateral

Question 25

What are the 3 components to the levator ani muscles?

Answer 25

Iliococcygenus Pubococcygeus Puborectalis

Question 26

The coccygenus portion of the pelvic diaphragm covers what?

Answer 26

sacrospinous ligament

Question 27

Do other muscles assist the muscles of the pelvic diaphragm?

Answer 27

yes. pelvic diaphragm assisted by pitiformis and obturator internus m

Question 28

between 2 thighs there are 2 triangular regions. What are they?

Answer 28

urogenital triangle anal triangle

Question 29

What is the passageway in the urogenital triangle?

Answer 29

passageway of urinary and genital system

Question 30

What is the passageway of the anal traingle?

Answer 30

passage of rectum and anus

Question 31

What is the perineum?

Answer 31

a membrane beneath the pelvic muscles

Question 32

What is the perineal body?

Answer 32

the connection between the anal triangle and the urogenital triangle

Question 33

What is the perineal membrane?

Answer 33

Extends inferiorly posteriorly and anteriorly to hold the deep transverse perinneal mm in the deep perineal pouch this is the urogenital diaphragm

Question 34

What muscles are present in the male deep perinneal pouch?

Answer 34

deep transverse perinneal mm external urethral sphincter

Question 35

What muscles are present in the female deep perinneal pouch?

Answer 35

deep transverse perinneal mm external urethral sphincter compressor urethrae mm sphincter urethrovaginalis mm

Question 36

What are the pelvic viscera?

Answer 36

Ureters, Bladder, Urethra, Rectum, Anal Canal, Uterus (women), external genitalia

Question 37

What does the deep transverse perineal mm blend with?

Answer 37

sphincter mm of urethra in vagina (female)

Question 38

How do the ureters get into the pelvis? How to get to bladder?

Answer 38

cross the external iliac vessels and descend into pelvis Travel to posterolateral aspect of urinary bladder

Question 39

How does ureter get to bladder in females?

Answer 39

"water under the bridge" Ureter runs posterior ("under") the uterine artery

Question 40

How does ureter get to bladder in males?

Answer 40

ductus deferens crosses ureter

Question 41

What is the muscle in urinary bladder?

Answer 41

smooth muscle detrusor urinae

Question 42

What is detrusor urinae?

Answer 42

smooth muscle in the urinary bladder

Question 43

What is inferior extend of female bladder?

Answer 43

perineum and pubivesical ligament

Question 44

What is inferior extend of male bladder?

Answer 44

pubovesical ligament, perineum and prostate

Question 45

Where is the prostate found?

Answer 45

between the bladder and perineum

Question 46

What is the passageway of the urethra in relation to the prostate?

Answer 46

The urethra passes through the prostate think: prostatic urethra

Question 47

The female urethra pierces the anterior portion of the _____ between what?

Answer 47

pierces anterior portion of urogenital diaphragm between the bladder and external urethral orifice

Question 48

What is periurethral gland?

Answer 48

lubricating opening of urethra and protecting epithelium against the urine itself aka skene's gland

Question 49

What are the portions of the male urethra?

Answer 49

pre-prostatic portion prostatic portion membraneous portion spongy/penile urethra

Question 50

Pre-prostatic part of male urethra?

Answer 50

very small

Question 51

What part of the male urethra is where the urogenital tracts combine?

Answer 51

prostatic portion

Question 52

What portion of the male urethra passes through the perineum?

Answer 52

the membraneous urethra

Question 53

What portion of the male urethra goes to the external urethral orifice?

Answer 53

spongy/penile urethra

Question 54

Rectum is normally constricted by ____

Answer 54

puborectal sling (which is the puborectalis muscle of the levator ani) "u shaped"

Question 55

What is the puborectal sling?

Answer 55

part of the puborectalis muscle of the levator ani that contsributs the rectum "u shaped"

Question 56

What is the anal rectal flexure created by?

Answer 56

puborectalis mm (the most medial portion of this mm) anal rectal flexure is when it turns from rectal to anal

Question 57

Anal canal emerges in ___, ____ to pelvis floor

Answer 57

emerges at anal triangle inferior to pelvic floor

Question 58

Anal canal is continuous with ___ at ____.

Answer 58

rectum at anorectal junction | curvature of perineal junction forms anorectal flexure

Question 59

What are the 3 male reproductive galnds?

Answer 59

1. seminal vesicles 2. prostate galnd 3. bulbourethral (cowper's) gland

Question 60

Where are seminal vesicles?

Answer 60

join the vas deferens and empties into prostatic urethra forms ejaculatory ducts

Question 61

How big is the prostate gland and where is it located?

Answer 61

walnut sized between bladder and urogenital diaphragm

Question 62

Where are bulbo-urethral gland? How big? Where does it empty?

Answer 62

in deep perinneal pouch, within urogenital diaphragm empties into penile urethra 2 pea sized balls

Question 63

Uterine tubes are an open channel from ____ to ____

Answer 63

peritoneal cavity to uterus

Question 64

What are the 4 parts of the uterine tube?

Answer 64

fimbriae, infundibulum, ampulla, isthmus

Question 65

The uterus is ___ long and enlarges ___x during pregnancy

Answer 65

7cm 20x

Question 66

How is the uterus oriented in the pelvic cavity?

Answer 66

anteverted at right angle to vaginal canal

Question 67

What is the uterine cervix?

Answer 67

inferior neck of uterus protruding into vaginal canal

Question 68

External os is opening of ___ into the ____

Answer 68

opening of cervix into vagina

Question 69

Internal os is opening of ___ into the ___

Answer 69

opening uterus to cervical canal

Question 70

What is the vaginal fornix? What is it's orientation?

Answer 70

circular gutter surrounding cervix deeper posterior than anterior

Question 71

What are the uterine ligaments?

Answer 71

1. suspensory ligament 2. broad ligament 3. ovarian ligament 4. round ligament of the uterus

Question 72

What is the suspensory ligament of the ovary?

Answer 72

peritoneum covering OVARIAN VESSELS and NERVES

Question 73

What is the broad ligament?

Answer 73

peritoneum covering uterus and adnexa (adnexa = tubes and ovaries)

Question 74

What is adnexa?

Answer 74

tubes and ovaries

Question 75

What is the ovarian ligament? What is embryological derivative?

Answer 75

anchors ovary to uterus aka ovarian ligament proper gubernaculum derivative

Question 76

What is the round ligament of the uterus?

Answer 76

continuation of the ovarian ligament passes through inguinal canal to fuse with labia majora

Question 77

What is the mesovarium?

Answer 77

posterior extension of the broad ligament